Individual provider Active NPI

Kathryn Mahoney Hancock, FNP-BC

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1831073857
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
005359 Issued in GA
Practice address
765 Lanier 400 Pkwy # a
Cumming, GA 30040-2539
Phone
(770) 205-1294
NPI assigned
Aug 4, 2025
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 005359 GA Primary

Addresses

Primary practice location

765 Lanier 400 Pkwy # a
Cumming, GA 30040-2539

Mailing address

2810 Burgundy Dr
Cumming, GA 30041-8031
Phone (770) 845-7446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009000006 TN Practitioner - Nurse Practitioner 0345747994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4998 Crossings Cir
Suite 100
Mount Juliet, TN 37122-2996
Phone (615) 288-4087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39337TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Tennessee LLC CurrentSince Sep 12, 2025 Accepting new patients
Privia Medical Group Tennessee LLC Family Medicine CurrentSince Sep 12, 2025 Accepting new patients

Locations

1009 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7181

4998 Crossings Cir
Ste 100
Mt Juliet, TN 37122
Phone (615) 288-4087

Interoperability endpoints

  • Direct secure messaging: kathryn.hancock.1@25094.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1831073857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 BURGUNDY DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418031",
            "telephone_number": "770-845-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LANIER 400 PKWY # A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402539",
            "telephone_number": "770-205-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "KATHRYN",
        "middle_name": "MAHONEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "005359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.